Big Bite: Puberty Blockers are Reversible?
Big bite | A detailed dive into big news
U.S. Department of Health and Human Services (HHS) issued an official document entitled "Gender-Affirming Care and Young People."
HHS Office of Population Affairs, unsupported claim of the reversibility of puberty blockers, in their Gender Affirming Care and Young People guidlenes.
Puberty blockers are gonadotropin-releasing hormone agonists, known as Lupron (Leuprolide).
Lupron is used to treat prostate cancer, endometriosis, fibrous, and central precocious puberty (CCP).
Some known side effects of on-label use of Lupron
may cause impotence
loss of bone density
increase risk of heart attack and stroke
Off-label uses for Lupron are puberty blockers as part of “gender-affirming care” in children and chemical castration for sex offenders.
Lupron and other puberty blockers that are used to halt Central Precocious Puberty have been shown to be reversible. In the treatment of CPP the child stops using the puberty blockers once they reach the age of natal puberty. No such studies exist for puberty blockers administered to stop normally timed puberty.
When used in “gender-affirming care” the child's natal puberty is sttopped and if they chose to transition the cross-sex hormones are introduced and the child never goes through natal puberty. There are currently no studies into the long-term effects of children who never experience natal puberty.
Concerns about possible side-effects of off label use
harm to bone development
harm to brain development
unknown effect on other vital organs
loss of fertility
unable to experience orgasm
UK’s NHS, updated guidance, “Little is known about the long-term effects of hormone or puberty blockers in children with gender dysphoria”
Vrouenraets LJ, Fredriks AM, Hannema SE, Cohen-Kettenis PT, de Vries MC. Early Medical Treatment of Children and Adolescents With Gender Dysphoria: An Empirical Ethical Study. J Adolesc Health. 2015;57(4):367-373. doi:10.1016/j.jadohealth.2015.04.004
O'Connell MA, Nguyen TP, Ahler A, Skinner SR, Pang KC. Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents. J Clin Endocrinol Metab. 2022;107(1):241-257. doi:10.1210/clinem/dgab634
Giordano S, Holm S. Is puberty delaying treatment 'experimental treatment'?. Int J Transgend Health. 2020;21(2):113-121. Published 2020 Apr 11. doi:10.1080/26895269.2020.1747768
The Cass review, interim report: “it is important that it is not assumed that outcomes for, and side effects in, children treated for precocious puberty will necessarily be the same in children or young people with gender dysphoria.”